Dimitra Koulocheri - Academia.edu (original) (raw)

Papers by Dimitra Koulocheri

Breast Cancer, Dec 13, 2012

Mammography is currently the standard breast cancer screening procedure, even though it is constr... more Mammography is currently the standard breast cancer screening procedure, even though it is constrained by low specificity in the detection of malignancy and low sensitivity in women with dense breast tissue. Modern imaging modalities, such as magnetic resonance imaging (MRI), have been developed in an effort to replace or complement mammography, because the early detection of breast cancer is critical for efficient treatment and long-term survival of patients. Nuclear medicine imaging technology has been introduced in the field of oncology with the development of positron emission tomography (PET), positron emission tomography/computed tomography (PET/CT) and, ultimately, positron emission mammography (PEM). PET offers the advantage of precise diagnosis, by measuring metabolism with the use of a radiotracer and identifying changes at the cellular level. PET/CT imaging allows for a more accurate assessment by merging the anatomic localization to the functional image. However, both techniques have not yet been established as diagnostic tools in early breast cancer detection, primarily because of low sensitivity, especially for sub-centimeter and low-grade tumors. PEM, a breast-specific device with increased spatial resolution, has been developed in order to overcome these limitations. It has demonstrated higher detectability than PET/CT and comparable or better sensitivity than MRI. The ability to target the lesions visible in PEM with PEM-guided breast biopsy systems adds to its usability in the early diagnosis of breast cancer. The results from recent studies summarized in this review indicate that PEM may prove to be a useful first-line diagnostic tool, although further evaluation and improvement are required.

Medinfo 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics; Building Sustainable Health Systems, 2007

According to the World Health Organisation, breast cancer is the second leading cause of cancer d... more According to the World Health Organisation, breast cancer is the second leading cause of cancer deaths in women today and is the most common cancer among women, excluding nonmelanoma skin cancers. Several studies have proved that the early detection of breast cancer can reduce mortality rates and improve the chances that the patient is diagnosed at an early stage and treated successfully. Mammography is widely used as the primary method for breast cancer detection. Breast microcalcifications usually appear in the form of clusters and sometimes can be easily detected on mammografic films due to their high clustering density. An approach in the classification of microcalcifications has been presented by Ligomenides et al. and it is based on detailed analysis and evaluation of seven features of individual microcalcifications and of formed clusters. The proposed system is now in clinical trial in an Athens University Hospital's Breast Unit. The results from the first 51 cases (all biopsy tested) that were processed are presented in this paper and indicate that all malignant cases were classified correctly.

The Breast, Mar 1, 2015

is fully employed by Roche d.o.o. Roche d.o.o. is sponsor of the project BreastCare from which da... more is fully employed by Roche d.o.o. Roche d.o.o. is sponsor of the project BreastCare from which data are generated.

Clinical Radiology, Jun 1, 2008

Oncology Research and Treatment, 2008

This study evaluates the underestimation rate of papilloma lesions diagnosed with vacuum-assisted... more This study evaluates the underestimation rate of papilloma lesions diagnosed with vacuum-assisted breast biopsy (VABB), taking into consideration the greater volume excised. 56 women with a diagnosis of a papilloma lesion after VABB (Mammotest; Fischer Imaging, Denver, CO, USA) were evaluated. At least 24 cores were excised in all cases (mean 74, range 24-96 cores) and a preoperative diagnosis was established. Subsequently, open surgery using hook-wire localization followed. A second, postoperative diagnosis was independently and blindly made. The association between the pathological types and Breast Imaging Report and Data System (BI-RADS) classification, as well as the discrepancy between preoperative and postoperative diagnoses, was evaluated. The underestimation rate of papillary lesions was 3.6%. When the papillary lesions did not coexist preoperatively with any other precursor breast lesions, the underestimation rate was 0%. The underestimation rate did not differ with age, BI-RADS category or type of lesion. Conservative management of patients with a papillary lesion diagnosis may follow when the extended VABB protocol is adopted and a great tissue volume is excised. However, when diagnosing a coexisting papillary lesion with a precursor breast lesion, open surgery should follow, given the high probability of a postoperative cancer diagnosis.

The Breast, Dec 1, 2008

Introduction: To assess the putative predictors that may be implicated in the pain experienced du... more Introduction: To assess the putative predictors that may be implicated in the pain experienced during stereotactic vacuum-assisted breast biopsy (VABB). Materials and methods: One hundred and thirty-five consecutive women with microcalcifications underwent VABB on the Fischer's table. The visual analogue scale was used to measure the degree of the ''average pain'' (AP). Results: At the univariable analysis, the AP was positively associated with the duration of the procedure, the diagnosis of malignant/preinvasive lesions and the volume of blood lost. Although menopausal status was not associated with the AP, within the premenopausal subpopulation, luteal phase was associated with higher VAS score. These findings also persisted at the multivariable ordinal logistic regression model. However, the mean experienced pain was associated neither with the volume of tissue excised nor with the hematoma formation, nor with patients' age. Conclusion: The aforementioned factors were independent positive predictors of the mean experienced pain during VABB.

The Breast, Mar 1, 2011

Goals: The Breast Lesion Excision System by Intact ® (BLES) is a novel, automated, stereotactic v... more Goals: The Breast Lesion Excision System by Intact ® (BLES) is a novel, automated, stereotactic vacuum-assisted breast biopsy device that utilizes radiofrequency in order to excise non-palpable mammographic lesions for pathologic diagnosis. The purpose of this prospective clinical study is to examine pain in women undergoing breast biopsy with the use of BLES. Methods: In the present study we included 72 consecutive women aged 54±9.6 years (range 36−74) that underwent breast biopsy for suspicious non-palpable mammographic lesions with the use of BLES. The inclusion criteria consisted of microcalcifications, solid lesions and asymmetric density, classified as BI-RADS 4. We used the 12 mm, 15 mm or 20 mm tissue basket, depending on the size of the lesion, under local anesthesia, in a prone position using the Fischer's ® stereotactic table. For the quantification of pain experience, visual analogue scale (VAS) was used in the procedure room (0−10 scale). The patients were asked to retrospectively indicate the pain defined as the VAS score where a rating of zero indicated "no pain" and 10 indicated "worst possible pain". Results: The procedure was successful and uneventful in all cases. In our patient sample, the pain VAS score was 4.11±2.6 (range 0−9). The mean experienced pain was not associated with the basket size used, the type of the lesion or the ACR Breast Composition classification. Conclusion: According to our initial experience, breast biopsy with the use of BLES seems to be a relatively painful procedure, although it may be equally or less painful than other minimally invasive biopsy methods for the excision of non-palpable mammographic lesions. Disclosure of Interest: None Declared P168 3 Tesla MRI is more useful for the evaluation of tumor extent of breast cancer: a comparative study with conventional 1.5 Tesla MRI

Acta Radiologica, Feb 1, 2008

CardioVascular and Interventional Radiology, Apr 1, 1996

Two patients with cardiac involvement of hydatid disease are presented: one with hydatid cyst of ... more Two patients with cardiac involvement of hydatid disease are presented: one with hydatid cyst of the interventricular septum and pulmonary arteries and the other with multiple pulmonary cysts associated with intracardiac and pericardial cysts. The ability of magnetic resonance imaging (MRI) to provide a global view of cardiac anatomy in any plane with high contrast between flowing blood and soft tissue ensures it an important role in the diagnosis and preoperative assessment of hydatid disease of the heart.

Acta Radiologica, 2008

A 42-year-old woman underwent vacuum-assisted breast biopsy (VABB, 11G) due to a nonpalpable, BI-... more A 42-year-old woman underwent vacuum-assisted breast biopsy (VABB, 11G) due to a nonpalpable, BI-RADS 4A lesion without microcalcifications. During the procedure, an extraordinarily large amount of blood was lost. In an attempt to stop the hemorrhage and limit the imminent hematoma, a thin intravascular Fogarty catheter was inserted adjacent to the VABB probe (through the same incision). The catheter was maintained in its position for 2 days. At clinical examination 9 days after VABB, no hematoma was present. The use of a Fogarty catheter seems capable of limiting any severe bleeding after VABB and may also possibly prevent subsequent hematoma formation.

Breast Cancer, Mar 16, 2013

Stereotactic vacuum assisted breast biopsy (VABB) procedures remain of key importance in the diag... more Stereotactic vacuum assisted breast biopsy (VABB) procedures remain of key importance in the diagnostic evaluation of suspicious non-palpable mammographic lesions. The Breast Lesion Excision System(®) (BLES) is an image-guided percutaneous biopsy method that utilizes radiofrequency (RF) in order to retrieve an intact-tissue biopsy specimen. The purpose of this study is to determine the effects of RF application on the tissue specimen and the possible interference with the histopathologic results. In this study we included 265 patients with suspicious non-palpable mammographic lesions who underwent 273 stereotactic VABB procedures using the BLES. All biopsies were performed by the same surgical-radiology team under local anesthesia. The specimen thermal damage was classified according to the pathology report in 3 categories: Severe (extensive thermal damage or inability to diagnose), medium (ability to diagnose but either circumferential damage >1.5 mm or diffuse areas of thermal damage) and mild (circumferential thermal damage <1.5 mm but >0.5 mm). Radiofrequency-associated thermal damage of the specimen was observed in 14 cases (5.13 %), and was classified as severe in 5, medium in 5, and mild in 4 specimens. Within the group of RF damaged specimens, we found a significant (p < 0.05) positive correlation between fat cell content and classification of thermal damage. Although thermal damage is of concern during BLES breast biopsy, the incidence is low, and the outcome of the histopathologic assessment is not affected even in severely damaged specimens. Increased thermal damage seems to correlate with higher fat cell content of the specimen.

European Radiology, Sep 14, 2014

Breast Journal, Mar 1, 2020

Groups of suspicious calcifications present a common finding among screening and symptomatic popu... more Groups of suspicious calcifications present a common finding among screening and symptomatic population. Calcifications have been shown to be present in up to 50% of malignant lesions and in up to 84% of ductal carcinomas in situ (DCIS) found on mammograms. 1,2 At present, stereotactic core needle biopsy (CB) or vacuum-assisted biopsy (VAB) techniques are the gold standard initial diagnostic methods. 3-7 The literature concordance rate of stereotactic CB using a 14-gauge needle with the final surgical result is 87%-96%, and the sensitivity is 65%-97%. 6,8 VAB techniques using a 11-gauge needle under stereotactic guidance have been shown to increase the sensitivity up to 98%. 6 The underestimation rate seems to be related

Breast cancer is a leading cause of deaths in women. Mammography is considered as the most effect... more Breast cancer is a leading cause of deaths in women. Mammography is considered as the most effective technology presently available for breast cancer screening, being very effective in the detection of clustered microcalcifications which are considered as one of the most important findings associated to the existence of breast cancer. A computer aided diagnosis (CAD) system named ldquoHippocrates-mstrdquo has been

Archives of breast cancer, Apr 15, 2021

either under stereotactic or ultrasound guidance with high effectiveness and safety. It has been ... more either under stereotactic or ultrasound guidance with high effectiveness and safety. It has been shown that it is a good alternative to core needle biopsy (CB) and vacuum assisted biopsy (VAB) techniques with 1-5 similar accuracy and complication rates. The underestimation rates of the technique are also comparable to those of VAB regarding high-risk 6, 7 lesions and ductal carcinoma in situ (DCIS). Moreover, due to its unique advantage of excising an intact piece of breast tissue with preserved tissue margins, the effectiveness of the 100 ARTICLE INFO Background: The aim of the study was to retrospectively evaluate possible imaging and histopathology criteria that can be used in a clinical basis to assess the success of excision of suspicious calcifications using the breast lesion excision system (BLES). Methods: We investigated 400 BLES stereotactic biopsies of suspicious calcifications with the mean size of 15.38 mm (st. dev.= 13.579 mm, range 3-78 mm) using a 20 mm probe performed in our department between January 2014 and 2016. The mean age of our population was 58.5 years old (range 39-78 years). The pathology results of BLES specimens were compared with the final surgical results to assess excision success rates. Possible imaging and histopathology criteria for removal were statistically analyzed (mammographic size, disease free margins, grade, comedo phenotype, molecular type). Results: The results showed that 90/400 (22.5%) biopsies were cancers (80% DCIS) and 38/400 were lesions with cell atypia (9.5%) of which 29/38 had subsequent surgery and were included in the study. Excision was achieved in 31/90 cancers (34.4%) and in 23/29 lesions with cell atypia (76.3%). The imaging and histopathology criteria for BLES excision that could be potentially clinically assessed were the initial mammographic size (p<0.001), the distance of the lesion from the specimen margins (p<0.001), the presence of comedo necrosis (p=0.014) and the grade of the cancers (p=0.021). The underestimation rate was 15.5%. Conclusion: the mammographic size, grade, comedo presence and disease-free margins, were the main criteria for BLES success rate of excision of suspicious calcifications.

Breast Cancer, Dec 13, 2012

Mammography is currently the standard breast cancer screening procedure, even though it is constr... more Mammography is currently the standard breast cancer screening procedure, even though it is constrained by low specificity in the detection of malignancy and low sensitivity in women with dense breast tissue. Modern imaging modalities, such as magnetic resonance imaging (MRI), have been developed in an effort to replace or complement mammography, because the early detection of breast cancer is critical for efficient treatment and long-term survival of patients. Nuclear medicine imaging technology has been introduced in the field of oncology with the development of positron emission tomography (PET), positron emission tomography/computed tomography (PET/CT) and, ultimately, positron emission mammography (PEM). PET offers the advantage of precise diagnosis, by measuring metabolism with the use of a radiotracer and identifying changes at the cellular level. PET/CT imaging allows for a more accurate assessment by merging the anatomic localization to the functional image. However, both techniques have not yet been established as diagnostic tools in early breast cancer detection, primarily because of low sensitivity, especially for sub-centimeter and low-grade tumors. PEM, a breast-specific device with increased spatial resolution, has been developed in order to overcome these limitations. It has demonstrated higher detectability than PET/CT and comparable or better sensitivity than MRI. The ability to target the lesions visible in PEM with PEM-guided breast biopsy systems adds to its usability in the early diagnosis of breast cancer. The results from recent studies summarized in this review indicate that PEM may prove to be a useful first-line diagnostic tool, although further evaluation and improvement are required.

Medinfo 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics; Building Sustainable Health Systems, 2007

According to the World Health Organisation, breast cancer is the second leading cause of cancer d... more According to the World Health Organisation, breast cancer is the second leading cause of cancer deaths in women today and is the most common cancer among women, excluding nonmelanoma skin cancers. Several studies have proved that the early detection of breast cancer can reduce mortality rates and improve the chances that the patient is diagnosed at an early stage and treated successfully. Mammography is widely used as the primary method for breast cancer detection. Breast microcalcifications usually appear in the form of clusters and sometimes can be easily detected on mammografic films due to their high clustering density. An approach in the classification of microcalcifications has been presented by Ligomenides et al. and it is based on detailed analysis and evaluation of seven features of individual microcalcifications and of formed clusters. The proposed system is now in clinical trial in an Athens University Hospital's Breast Unit. The results from the first 51 cases (all biopsy tested) that were processed are presented in this paper and indicate that all malignant cases were classified correctly.

The Breast, Mar 1, 2015

is fully employed by Roche d.o.o. Roche d.o.o. is sponsor of the project BreastCare from which da... more is fully employed by Roche d.o.o. Roche d.o.o. is sponsor of the project BreastCare from which data are generated.

Clinical Radiology, Jun 1, 2008

Oncology Research and Treatment, 2008

This study evaluates the underestimation rate of papilloma lesions diagnosed with vacuum-assisted... more This study evaluates the underestimation rate of papilloma lesions diagnosed with vacuum-assisted breast biopsy (VABB), taking into consideration the greater volume excised. 56 women with a diagnosis of a papilloma lesion after VABB (Mammotest; Fischer Imaging, Denver, CO, USA) were evaluated. At least 24 cores were excised in all cases (mean 74, range 24-96 cores) and a preoperative diagnosis was established. Subsequently, open surgery using hook-wire localization followed. A second, postoperative diagnosis was independently and blindly made. The association between the pathological types and Breast Imaging Report and Data System (BI-RADS) classification, as well as the discrepancy between preoperative and postoperative diagnoses, was evaluated. The underestimation rate of papillary lesions was 3.6%. When the papillary lesions did not coexist preoperatively with any other precursor breast lesions, the underestimation rate was 0%. The underestimation rate did not differ with age, BI-RADS category or type of lesion. Conservative management of patients with a papillary lesion diagnosis may follow when the extended VABB protocol is adopted and a great tissue volume is excised. However, when diagnosing a coexisting papillary lesion with a precursor breast lesion, open surgery should follow, given the high probability of a postoperative cancer diagnosis.

The Breast, Dec 1, 2008

Introduction: To assess the putative predictors that may be implicated in the pain experienced du... more Introduction: To assess the putative predictors that may be implicated in the pain experienced during stereotactic vacuum-assisted breast biopsy (VABB). Materials and methods: One hundred and thirty-five consecutive women with microcalcifications underwent VABB on the Fischer's table. The visual analogue scale was used to measure the degree of the ''average pain'' (AP). Results: At the univariable analysis, the AP was positively associated with the duration of the procedure, the diagnosis of malignant/preinvasive lesions and the volume of blood lost. Although menopausal status was not associated with the AP, within the premenopausal subpopulation, luteal phase was associated with higher VAS score. These findings also persisted at the multivariable ordinal logistic regression model. However, the mean experienced pain was associated neither with the volume of tissue excised nor with the hematoma formation, nor with patients' age. Conclusion: The aforementioned factors were independent positive predictors of the mean experienced pain during VABB.

The Breast, Mar 1, 2011

Goals: The Breast Lesion Excision System by Intact ® (BLES) is a novel, automated, stereotactic v... more Goals: The Breast Lesion Excision System by Intact ® (BLES) is a novel, automated, stereotactic vacuum-assisted breast biopsy device that utilizes radiofrequency in order to excise non-palpable mammographic lesions for pathologic diagnosis. The purpose of this prospective clinical study is to examine pain in women undergoing breast biopsy with the use of BLES. Methods: In the present study we included 72 consecutive women aged 54±9.6 years (range 36−74) that underwent breast biopsy for suspicious non-palpable mammographic lesions with the use of BLES. The inclusion criteria consisted of microcalcifications, solid lesions and asymmetric density, classified as BI-RADS 4. We used the 12 mm, 15 mm or 20 mm tissue basket, depending on the size of the lesion, under local anesthesia, in a prone position using the Fischer's ® stereotactic table. For the quantification of pain experience, visual analogue scale (VAS) was used in the procedure room (0−10 scale). The patients were asked to retrospectively indicate the pain defined as the VAS score where a rating of zero indicated "no pain" and 10 indicated "worst possible pain". Results: The procedure was successful and uneventful in all cases. In our patient sample, the pain VAS score was 4.11±2.6 (range 0−9). The mean experienced pain was not associated with the basket size used, the type of the lesion or the ACR Breast Composition classification. Conclusion: According to our initial experience, breast biopsy with the use of BLES seems to be a relatively painful procedure, although it may be equally or less painful than other minimally invasive biopsy methods for the excision of non-palpable mammographic lesions. Disclosure of Interest: None Declared P168 3 Tesla MRI is more useful for the evaluation of tumor extent of breast cancer: a comparative study with conventional 1.5 Tesla MRI

Acta Radiologica, Feb 1, 2008

CardioVascular and Interventional Radiology, Apr 1, 1996

Two patients with cardiac involvement of hydatid disease are presented: one with hydatid cyst of ... more Two patients with cardiac involvement of hydatid disease are presented: one with hydatid cyst of the interventricular septum and pulmonary arteries and the other with multiple pulmonary cysts associated with intracardiac and pericardial cysts. The ability of magnetic resonance imaging (MRI) to provide a global view of cardiac anatomy in any plane with high contrast between flowing blood and soft tissue ensures it an important role in the diagnosis and preoperative assessment of hydatid disease of the heart.

Acta Radiologica, 2008

A 42-year-old woman underwent vacuum-assisted breast biopsy (VABB, 11G) due to a nonpalpable, BI-... more A 42-year-old woman underwent vacuum-assisted breast biopsy (VABB, 11G) due to a nonpalpable, BI-RADS 4A lesion without microcalcifications. During the procedure, an extraordinarily large amount of blood was lost. In an attempt to stop the hemorrhage and limit the imminent hematoma, a thin intravascular Fogarty catheter was inserted adjacent to the VABB probe (through the same incision). The catheter was maintained in its position for 2 days. At clinical examination 9 days after VABB, no hematoma was present. The use of a Fogarty catheter seems capable of limiting any severe bleeding after VABB and may also possibly prevent subsequent hematoma formation.

Breast Cancer, Mar 16, 2013

Stereotactic vacuum assisted breast biopsy (VABB) procedures remain of key importance in the diag... more Stereotactic vacuum assisted breast biopsy (VABB) procedures remain of key importance in the diagnostic evaluation of suspicious non-palpable mammographic lesions. The Breast Lesion Excision System(®) (BLES) is an image-guided percutaneous biopsy method that utilizes radiofrequency (RF) in order to retrieve an intact-tissue biopsy specimen. The purpose of this study is to determine the effects of RF application on the tissue specimen and the possible interference with the histopathologic results. In this study we included 265 patients with suspicious non-palpable mammographic lesions who underwent 273 stereotactic VABB procedures using the BLES. All biopsies were performed by the same surgical-radiology team under local anesthesia. The specimen thermal damage was classified according to the pathology report in 3 categories: Severe (extensive thermal damage or inability to diagnose), medium (ability to diagnose but either circumferential damage &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1.5 mm or diffuse areas of thermal damage) and mild (circumferential thermal damage &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;1.5 mm but &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.5 mm). Radiofrequency-associated thermal damage of the specimen was observed in 14 cases (5.13 %), and was classified as severe in 5, medium in 5, and mild in 4 specimens. Within the group of RF damaged specimens, we found a significant (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) positive correlation between fat cell content and classification of thermal damage. Although thermal damage is of concern during BLES breast biopsy, the incidence is low, and the outcome of the histopathologic assessment is not affected even in severely damaged specimens. Increased thermal damage seems to correlate with higher fat cell content of the specimen.

European Radiology, Sep 14, 2014

Breast Journal, Mar 1, 2020

Groups of suspicious calcifications present a common finding among screening and symptomatic popu... more Groups of suspicious calcifications present a common finding among screening and symptomatic population. Calcifications have been shown to be present in up to 50% of malignant lesions and in up to 84% of ductal carcinomas in situ (DCIS) found on mammograms. 1,2 At present, stereotactic core needle biopsy (CB) or vacuum-assisted biopsy (VAB) techniques are the gold standard initial diagnostic methods. 3-7 The literature concordance rate of stereotactic CB using a 14-gauge needle with the final surgical result is 87%-96%, and the sensitivity is 65%-97%. 6,8 VAB techniques using a 11-gauge needle under stereotactic guidance have been shown to increase the sensitivity up to 98%. 6 The underestimation rate seems to be related

Breast cancer is a leading cause of deaths in women. Mammography is considered as the most effect... more Breast cancer is a leading cause of deaths in women. Mammography is considered as the most effective technology presently available for breast cancer screening, being very effective in the detection of clustered microcalcifications which are considered as one of the most important findings associated to the existence of breast cancer. A computer aided diagnosis (CAD) system named ldquoHippocrates-mstrdquo has been

Archives of breast cancer, Apr 15, 2021

either under stereotactic or ultrasound guidance with high effectiveness and safety. It has been ... more either under stereotactic or ultrasound guidance with high effectiveness and safety. It has been shown that it is a good alternative to core needle biopsy (CB) and vacuum assisted biopsy (VAB) techniques with 1-5 similar accuracy and complication rates. The underestimation rates of the technique are also comparable to those of VAB regarding high-risk 6, 7 lesions and ductal carcinoma in situ (DCIS). Moreover, due to its unique advantage of excising an intact piece of breast tissue with preserved tissue margins, the effectiveness of the 100 ARTICLE INFO Background: The aim of the study was to retrospectively evaluate possible imaging and histopathology criteria that can be used in a clinical basis to assess the success of excision of suspicious calcifications using the breast lesion excision system (BLES). Methods: We investigated 400 BLES stereotactic biopsies of suspicious calcifications with the mean size of 15.38 mm (st. dev.= 13.579 mm, range 3-78 mm) using a 20 mm probe performed in our department between January 2014 and 2016. The mean age of our population was 58.5 years old (range 39-78 years). The pathology results of BLES specimens were compared with the final surgical results to assess excision success rates. Possible imaging and histopathology criteria for removal were statistically analyzed (mammographic size, disease free margins, grade, comedo phenotype, molecular type). Results: The results showed that 90/400 (22.5%) biopsies were cancers (80% DCIS) and 38/400 were lesions with cell atypia (9.5%) of which 29/38 had subsequent surgery and were included in the study. Excision was achieved in 31/90 cancers (34.4%) and in 23/29 lesions with cell atypia (76.3%). The imaging and histopathology criteria for BLES excision that could be potentially clinically assessed were the initial mammographic size (p<0.001), the distance of the lesion from the specimen margins (p<0.001), the presence of comedo necrosis (p=0.014) and the grade of the cancers (p=0.021). The underestimation rate was 15.5%. Conclusion: the mammographic size, grade, comedo presence and disease-free margins, were the main criteria for BLES success rate of excision of suspicious calcifications.